| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L5673 |
Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism |
42 |
38 |
$14K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
42 |
38 |
$11K |
| L5637 |
Addition to lower extremity, below knee, total contact |
27 |
26 |
$10K |
| L5620 |
Addition to lower extremity, test socket, below knee |
27 |
26 |
$8K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
27 |
26 |
$7K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
27 |
26 |
$4K |